Module 6

Question 1

What % of blood is plasma

Answer 1

55%

Question 2

What % of blood is formed elements

Answer 2

45%

Question 3

Plasma is made of what components

Answer 3

water, proteins, electrolytes, and clotting factors

Question 4

how do platelets react to a vessel injury

Answer 4

the cytoplasmic granules release adhesive proteins, coagulation, and growth factors

Question 5

What is the normal platelet count

Answer 5

150,000 - 400,000

Question 6

what is the number of platelets that constitute thrombocytopenia

Answer 6

< 100,000

Question 7

what is the concern with thrombocytopenia

Answer 7

high risk of bleeding

Question 8

where are additional platelets stored

Answer 8

spleen

Question 9

where are platelets made

Answer 9

bone marrow

Question 10

platelets circulate in their __________ state

Answer 10

unactivated

Question 11

what are the 4 steps after platelets are activated

Answer 11

1. increased platelet adhesion
2. activation leading to platelet degranulation (release mediators)
3. aggregation as platelet-vascular wall and platelet-platelet adherence increases
4. activation of clotting system

Question 12

what is antithrombin III

Answer 12

a circulating inhibitor of thrombin (which stops the clotting process)

Question 13

what does tissue factor pathway inhibitor (TFPI) do

Answer 13

inhibits Xa

Question 14

what do tissue plasminogen activator and urokinase like plasminogen activator do

Answer 14

activates plasminogen to turn into plasmin which then breaks down fibrin

Question 15

what are the 5 goals of coagulation therapy

Answer 15

prevent clot formation
break apart an existing clot
can help increase circulation and perfusion
decrease pain
prevent further tissue damage

Question 16

biggest concern with anticoagulation therapy

Answer 16

bleeding

Question 17

what are later signs on bleeding evidenced by vital signs

Answer 17

decrease in BP, increased RR

Question 18

what are later signs of bleeding evidenced by inspection of the skin

Answer 18

ashen / gray color

Question 19

what do anti-platelet drugs do

Answer 19

prevent platelet plugs from forming by inhibiting platelet aggregation

Question 20

what happens with heparin induced thrombocytopenia

Answer 20

low platelet count and increased development of thrombi

Question 21

when looking at platelet count, when should you stop heparin

Answer 21

<100,000

Question 22

IV heparin is based on what clotting time labs

Answer 22

anti-Xa or aPTTT (activated partial thromboplastin time)

Question 23

what foods should you avoid on warfarin

Answer 23

high vitamin K foods - kale, brussel sprouts, pickled cucumber, kiwi fruit, green beans, broccoli, cabbage, asparagus, okra, lettuce

Question 24

what is a thrombus

Answer 24

a blood clot that remains attached to a vessel wall

Question 25

what is a thromboembolism

Answer 25

a blood clot that has become detached from a vessel wall

Question 26

what is a venous thromboembolism

Answer 26

a blood clot that is located in the venous circulation

Question 27

what is DVT

Answer 27

deep vein thrombosis - it is a blood clot located in one of the deep veins

Question 28

what is the triad of virchow (definition and parts)

Answer 28

definition: three factors that promote formation of a venous thrombosis factors: 1. venous stasis - old age, immobile, HF 2. venous endothelial damage - result of trauma, surgery, or some IV meds 3. hypercoagulability - increased clotting, can be genetic, pregnant, people who use oral contraceptives, surgery

Question 29

what are the 13 risk factors for DVT

Answer 29

1. clotting disorders 2. immobility 3. injury / surgery 4. pregnancy 5. oral contraceptives / hormone replacement therapy 6. overweight / obese 7. smoking 8. cancer / chemo 9. HF 10. IBD 11. hx of DVT or family hx 12. age > 60 13. varicose veins / spider veins

Question 30

what are the 4 most serious complications of DVT / VTE

Answer 30

1. PE 2. chronic thromboembolic pulmonary hypertension 3. post thrombotic syndrome 4. phlegmasia cerula dolens

Question 31

what is allostasis

Answer 31

dynamic process that supports / helps body return to set point

Question 32

what are s/s of allostatic overload

Answer 32

hair loss, tension, mouth sores, tension headaches, palpitations, tics, digestive disorders, acne, irritable bladder, irregular menstrual cycle, impotence, sleep disturbances

Question 33

what is the benefit of eustress

Answer 33

can help focus and motivate

Question 34

what is the problem of distress

Answer 34

it is a negative reaction that can have long term negative consequences

Question 35

what is coping and what does it focus on

Answer 35

strategies / action that are typically addressed towards the stressor

Question 36

what are the 3 stages of general adaptation syndrome

Answer 36

alarm, resistance, exhaustion

Question 37

in the stress response, when the hypothalamus is activated it can activate what two cascades

Answer 37

1. sympathetic nervous system 2. adrenal-cortical system

Question 38

what does the adrenal medulla release

Answer 38

norepinephrine and epinephrine

Question 39

what hormone actives the adrenal-cortical system

Answer 39

corticotropin releasing factor

Question 40

what hormone does the pituitary gland secrete

Answer 40

ACTH, adrenocorticotropin hormone

Question 41

where does ACTH go once it is released by the pituitary gland

Answer 41

adrenal cortex

Question 42

what 2 things happen with the brain when it is exposed to stress that isn't relieved and goes into the exhaustion phase

Answer 42

hypertrophy of adrenal cortex and atrophy of lymphatic tissue

Question 43

what does norepinephrine

Answer 43

dilates pupils, decrease gastric secretion, inhibits insulin secretion

Question 44

what does epinephrine

Answer 44

enhance heart contractility and heart rate, dilates airway, increase glycogenolysis, and inhibits insulin secretion

Question 45

glucocorticoids promote the synthesis of what

Answer 45

epinephrine

Question 46

glucocorticoids + __________ help develop memories

Answer 46

catecholamines

Question 47

what does cortisol do

Answer 47

increase CO and blood pressure, decrease estradiol, progesterone, and testosterone, increase level of amino acids (by increasing the breakdown of proteins, lymph nodes, and adipose tissue), stimulates gluconeogenesis, suppresses immune response, and causes atrophy of lymph tissue

Question 48

what is aldosterone an example of

Answer 48

mineralocorticoid

Question 49

what does aldosterone do

Answer 49

absorb Na+, excrete K+, increase BP

Question 50

what can happen is someone is sleep deprived

Answer 50

apathy, impaired memory, poor judgment, hallucinations

Question 51

why would we use steroids

Answer 51

replacement for those that have a deficiency, for anti-inflammatory properties, for immunosuppression, for asthma, COPD exacerbation, chronic IBD, or post-transplant